IPC Exam 1 Flashcards
hint
for exam questions: know your top OTC list!
exam questions
allergy and cough meds
brand
generic
pharm. category
ROA
OTC Facts & Figures
OTC products with approximately _800___ different active ingredients are currently available
U.S. consumers make _26__ trips a year to purchase OTC products. They only visit doctors, on average, three times a year.
__93__% of U.S. adults prefer to treat their minor ailments with OTC medicine before seeking professional care
85% of U.S. parents prefer to treat their children’s minor ailments with an OTC medicine before seeking professional care.
do not need to memorize the stats
OTC meds provide
$102 billion in value to the US healthcare
because trips to the doctor’s office is expensive and OTC is less expensive than the rx
physicians and consumers agree
OTC meds are the preferred first line of treatment
The Role of the Pharmacist in Self-Care
Pharmacists are the only healthcare professional that receives formalized training in over-the-counter (OTC) medication therapy.
common self-care requests
headache
what if they come and ask what you have for headaches
Quickly and accurately assess the patient
What should ALWAYS be the FIRST question you ask a patient requesting an OTC product?
- who is this medication for on exam
Ask about the current complaint (SCHOLAR)
Ask about pertinent medical history (MCPHS)
Quickly and accurately assess the patient: Ask about the current complaint (SCHOLAR)
S - symptoms, : What are the main and associated symptoms?
C - characteristics, how did it start, can you qualify it further, is it pounding, is it a tight band, What is the situation like, is it changing?
H - history, what have you done already, have you tried anything yet
O - onset, when did it start
L - location, where is the pain
A/R - Aggravating and remitting factors: what makes it better / what makes it worse?
this is all subjective, self-reported
Quickly and accurately assess the patient: Ask about the patient’s pertinent medical history (MCPHS)
M - medication
C - co-existing conditions, current disease conditions
P - products, ask about some new products they may be taking
H - hypersensitivites
S - social histories like alcohol and smoking and elicit categories, who do they live with
QuEST
Establish that the patient is an appropriate self-care candidate
- Verify if there are any exclusions to self-care
Suggest appropriate self-care strategies
Medication
- Nonprescription medication (OTC)
- Non-pharmacologic (“non-pharm”) recommendation
Talk with the patient
- About medication (actions and administration)
- About what to expect from treatment
- About appropriate follow-up
Qu: SCHOLAR MCPHS
E: Establish if the patient is an appropriate candidate for self-care.
- No, this patient is excluded from self-care
- Yes, this patient is a candidate for self-care treatment, with referral*
- Yes, this patient is a candidate for self-care (without referral)
if No, this patient is excluded from self-care - Refer to provider*
if Yes, this patient is a candidate for self-care treatment, with referral - Self care recommendation?
If yes, this patient is a candidate for self care (without referral) - *When should this patient follow up with their provider?
if yes to Self care recommendation? - Yes
Nonprescription Medication
+/- Nonpharmacologic
if yes to *When should this patient follow up with their provider? No
Non-Pharmacologic recommendation only
Why exclude a patient from self-care or require a referral?
Constraints of community pharmacy setting
- All information is self-reported / subjective information
- No labs, PE, health history
Potential severity of the condition
Self-treatment delays further evaluation
Requires prescription therapy
Underlying health conditions
Special populations (age, pregnancy, breastfeeding)
- May need further evaluation or may not be a nonprescription option
IG is a 21-year-old woman seeking a recommendation for her allergic rhinitis.
What is allergic rhinitis (mostly in nasal passages)? - allergy symptoms
What are typical symptoms? - runny nose, itching and sneezing
Allergic Rhinitis: Exclusions to Self Care
Red sign
Establish that the patient is an appropriate self care candidate:
Symptoms of non-allergic rhinitis:
- PMH of nasal polyps or nasal septal deviation
- Recent facial or head trauma
- Anosmia: loss or sense of smell
do not recommend non-Rx med., refer to provider, non-pharm meds - no
Symptoms of infection:
- Otitis media – ear pain, fever
- Sinusitis – sinus pain, thick nasal discharge
- Bronchitis – SOB, dyspnea
do not recommend non-Rx med., refer to provider STAT, non-pharm meds - no
Uncontrolled asthma or COPD – wheezing, SOB
do not recommend non-Rx med., refer to provider STAT, non-pharm meds - no
Allergic Rhinitis: Treatment with Referral
yellow sign
Establish that the patient is an appropriate self care candidate
pregnant/lactating women
do not recommend non-Rx med., refer to provider STAT, non-pharm meds - yes
children <12 years old
ages 2-4
do not recommend non-Rx med., refer to provider STAT, non-pharm meds - yes
> 4-12
do recommend non-Rx med., refer to provider STAT, non-pharm meds - yes
Which one of the following patients with allergic rhinitis is a candidate for self care without referral to their provider?
A. A 7-year-old boy with a PMH of ADHD with symptoms of a runny nose and itchy eyes
B. A 17-year-old woman with a PMH of dysmenorrhea with symptoms of nasal congestion and loss of smell
C. A 22-year-old man with a PMH of asthma with symptoms of rhinitis and nasal congestion
D. A 36-year-old woman with a PMH of atopic dermatitis with symptoms of sinus pain and thick nasal discharge
E. A 47-year-old man with a PMH of nasal polyps with symptoms of rhinitis and nasal congestion
this is an exam question for the summer
A 22-year-old man with a PMH of asthma with symptoms of rhinitis and nasal congestion
A needs to be referred because they are 7 years old
B - loss of smell needs to be referred
D- nasal pain and thick nasal discharge and that is a sign of sinus infection
E - polyps
List a nonprescription medication for allergic rhinitis
See Nonprescription Medication List….
rhinicort
zyrtec
loratidine
benadryl
Which one of the following is a first-generation antihistamine?
A. Cetirizine
B. Diphenhydramine
C. Fluticasone propionate
D. Loratadine
E. Triamcinolone
Diphenhydramine which is Benadryl
this is an exam question :)
also chlorpheniramine
Which one of the following is a second-generation antihistamine?
A
Brompheniramine
B
Chlorpheniramine
C
Fluticasone propionate
D
Loratadine
E
Triamcinolone
D
Loratadine - claritin
A
Brompheniramine
B
Chlorpheniramine are first gen
Which one of the following is an intranasal corticosteroid (INCS)?
A
Cetirizine
B
Doxylamine
C
Fexofenadine
D
Levocetirizine
E
Triamcinolone
E
Triamcinolone - nasacort
IG is a 21-year-old woman seeking a recommendation for her allergic rhinitis.
QuEST:SCHOLAR MCPHS
- Quickly and accurately assess the patient
- Establish that the patient is an appropriate self care candidate. Verify if there are any exclusion to self care
“My hay fever comes back every spring. What do you have that will last all day so I can study without remembering to take medication.”
Symptoms: “itchy nose, sneezing, nasal congestion and runny nose”
Characteristics: “symptoms get progressively worse as the pollen count increases”
History/onset: “occurs every spring”
Location: nose
Aggravating factors: being outside, having the windows open
Remitting factors: staying inside
Medication:
- Differin Gel
- Albuterol MDI
Comorbid conditions:
- Mild intermittent asthma
- Acne
Products: denies use of any herbals or other supplements
Hypersensitivities: ASA (bronchospasm, can’t breathe)
Social history: college student
Establish that the patient is an appropriate self-care candidate
yes she is
QuEST:SCHOLAR MCPHS
Suggest an appropriate self-care strategy:
Applying therapeutic principles: How to pick best option?
Select a medication that will:
- Treat condition (specific symptoms)
- Is supported by literature/treatment algorithm
Consider the patient’s preferences
Patient-specific parameters:
- Patient preferences/cost
- Drug allergies
- Drug-drug or drug-disease interactions
therapeutics is selecting the best medication for the patient
“My hay fever comes back every spring. What do you have that will last all day so I can study without remembering to take medication?”
Symptoms: “itchy nose, sneezing, nasal congestion and runny nose”
Characteristics: “symptoms get progressively worse as the pollen count increases”
History/onset: “occurs every spring”
Location: nose
Aggravating factors: being outside, having the windows open
Remitting factors: staying inside
Medication:
- Differin Gel
- Albuterol MDI
Comorbid conditions:
- Mild intermittent asthma
- Acne
Products: denies use of any herbals or other supplements
Hypersensitivities: ASA (bronchospasm)
Social history: college student
Review the drug facts label for these 3 options to determine what is MOST appropriate for this patient. First, consider her request for a product that will last all day so she can study.
Nasacort
Benadryl
Claritin
based on the drug facts, which one is best
claritin which is loratadine
Which one of the following is NOT an appropriate recommendation for IG?
A
Diphenhydramine
B
Loratadine
C
Triamcinolone
A
Diphenhydramine because the dosing frequency is every 4 to 6 hours but she wants something to last all-day and if she is studying and Benadryl makes you drowsy so we do not want that one
S: Suggest appropriate self-care strategies – Is this product appropriate for this patient?
What symptoms does each product relieve?
triamcinolone
loratadine
triamcinolone
- temp.relieves these symptoms of hay fever or other upper respiratory allergies
loratadine
- does not treat congestion
Which is the MOST appropriate nonprescription medication to treat IG’s symptoms?
A
Claritin
B
Nasacort
B
Nasacort which is triamcinolone
S: Suggest appropriate self-care strategies – Is this product appropriate for this patient?
What class of drugs may interact with the selected agent?
What disease states may interact with the selected agent?
